Friday, February 10, 2012

Feeling Lonely? Click…

If I were lonely, I could pay for match.com, eharmony.com, or Donna Shugrue’s Perfectly Matched dating service and a matrix-based formula would align me with Mr. Right. And if I were isolated, depressed, and wanted free companionship, I could click Get Your Free Quote at online-health-insurance.com, whose motto is “Health Insurance Online makes comparing quotes and finding affordable plans easy. Apply online or speak to an agent for cheap health insurance options.”

Free. Cheap. Those should’ve been my clues. But it was a Monday.

By applying online and not speaking to an agent (it did state “or” not “and”), I could put a person on the project of researching plans and rates for me, didn’t have to talk to a soul, and could work uninterrupted. Yep, back in management.

After entering my basic information on the site mentioned above—including my telephone number, I clicked for my free online quote. It was definitely a Monday.

The moment, and I mean moment, I clicked for my free quote, the phone rang. “Hello?”

“Hi, this is Doug, and I’m calling to talk to you about health insurance.”

“Noooooooo! How did this happen?” I have been on the National Do Not Call Registry since its inception, and I absolutely did not request a call, making his advance illegal.

After telling Doug to take my name off his list and hanging up, the phone rang incessantly till the predator gave up and started calling the next Monday moron. As I glanced at my computer, I counted nine U.S. predators that had spammed my email trying to get a piece of the commission pie. I felt very sick. The phone rang again and I spoke with Antonio, a guy who told me he lived in my city (but in a not-so-nice part of town). I said, “Are you at Daystar Terrace?”

“Ah, yeah. You must’ve gotten my email.”

I gave Antonio a chance after he went on for five minutes explaining to me how everyone and his brother got my information. I replied to his email more formally requesting my free quote. Well, it has been two weeks, and I’m still waiting for Mr. Briceno to write.

I unplugged the remote and powered off the answering machine. At 5:30 that afternoon when I plugged in my phone to recharge it, it immediately rang, as if they knew! I definitely had stepped in a pile of poo via that site I mentioned above.
This fiasco began with an announcement from Aetna, my health insurance provider. They are no longer offering individual plans in Colorado, so by midyear, I must select a new bloodsucker, just in case. Reminds me of an old satirical cartoon: A life insurance salesman says to a man and his wife, “That’s okay, Mr. Johnson, you just think about the policy, and if you wake up in the morning, give me a call.”

Last year I sought a different carrier via ehealthinsurance.com (a good experience), because Aetna had to be watched like I would a con man, that is to say, my ex-boyfriend. With every other claim, of which I have very few, Aetna either wouldn’t give me the agreed-upon rate between provider and insurer, or they’d simply refuse to pay their contractually obligated amount. I’d have to babysit Aetna, take my time to email them, explain their contractual agreement with the provider, and have them reprocess the claim.

Most of Aetna’s customer service reps didn’t write or understand American English, making this dance quite asynchronous. (They’ve recently hired English-writing Americans, probably due to my numerous complaints about having non-Americans wasting my time.) In 2008 it took one year of stressful aggravation and several appeals before they realized they had an agreement with a provider. They could have saved a lot of money had they initially hired native Americans.

In 2010 when I needed Mohs surgery for skin cancer, Aetna’s preauthorization representative said it would cost me only a $50 copay, so I proceeded with the dissection. When the actual bill came in at $2,000, I knew Aetna had erred and contacted them. Upon receiving my email, Aetna’s rep leaned back in her comfy office chair, filed her nails, and wrote (paraphrased), “The rep who told you your surgery would be covered with $50 was just kidding. What did you think the required preauthorization was anyway? It’s a cat-and-mouse game. Doesn’t mean a thing to us.”

Business law states, Aetna failed to honor their oral contract.

In this matter, I was fortunate for two reasons. First, I understand why Aetna would say they’d cover me then renege once the invoice was submitted. My friend works for a California insurance company here in the Springs and told me that when she denies a claim, she gets a kickback. She earns more money by not fulfilling the insurer’s contractual responsibility.

Second, I know about DORA, the Department of Regulatory Agencies, and for the first time in my life, a governmental organization was on my side; specifically, Deanna. This gal unceasingly helped me, from reading my initial request for assistance through completion, a process that took two months. She first contacted me via email, attaching the well-written, factually based letter addressed to Aetna. With the receipt of each DORA letter, Aetna would squirm and plant their heels into the ground, so my advocate, Deanna, would articulately, intelligently, and gracefully pull the rug from under Aetna’s sandy footing. Finally, Aetna admitted their trespasses, and to ensure I have no more claims, Aetna wrote me an assuring letter stating, next time anyone from their company says a procedure’s covered, don’t believe it.

Deanna is my hero and she knows it. I mailed her a thank you note telling her so. After all the travesties and injustices my daughter and I experienced in the Fourth Judicial District, DORA’s Deanna is a breath of fresh air. She’s probably gorgeous too.

So maybe I will start dating. Things are flowing more positively. Excuse me, phone’s ringing. “Hello?…yes, Brian,…health insurance? You have a very nice voice. Single?”

2 comments:

  1. Ha! I asked for information from probably that same online insurance company, except I didn't provide them with my "correct" phone number. That way they were forced to contact me via email. I think I actually used their own number in the request field. That was several years ago and I still get their spam emails after I indicated there was not a chance in the world I would do business with them.

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  2. I've always thought you were a better driver than I am and a little ahead of me in the common sense department, which is probably why I didn't think of using their number. That's a great idea!

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